lana-kuykendall

Early notice of flesh-eating bacteria may have saved mom

May 17, 2012 at 1:27 PM ET

With news reports of a second case of “flesh-eating bacteria” in less than a week, many Americans are beginning to worry about their own risk – and whether this type of rare infection is on the rise.

Just days after a Georgia woman was rushed to the hospital with a life-threatening infection that began in a wound she sustained in a zip-lining accident, Lana Kuykendall, a South Carolina mother of twins, sought help for a painful leg sore that turned out to be necrotizing fasciitis, the clinical name for flesh-eating bacteria.  

It’s not clear yet how Kuykendall’s leg became infected. She had just returned home after giving birth to her twins when she noticed a spot on the back of her left leg. Thinking it might be a blood clot, Kuykendall, who is a paramedic, checked herself in to the hospital.

“Around 11:30 it was the size of her palm,” Kuykendall’s friend, Kayla Moon, told TODAY. “By the time she went in to surgery and they thought they knew what it was, it had consumed practically her whole leg.”

As it turns out, Kuykendall’s quick trip to the hospital may have made all the difference. Doctors think she will not lose any limbs. Amy Copeland, the Georgia woman, wasn’t so lucky. She’s already had a leg amputated and may also lose some fingers.

Experts say that the only protection against damage from necrotizing fasciitis is vigilance. Though there are only 500-1,000 cases a year, a good 25 percent are fatal, NBC health editor Dr. Nancy Snyderman told TODAY’s Matt Lauer.

“Most victims will lose body tissue [and end up with] a dent in the leg or the loss of an appendage,” Snyderman said.

That’s because the only real treatment for necrotizing fasciitis is to remove all infected tissue, said Dr. William Pasculle, an associate professor of pathology, infectious disease and microbiology and director of microbiology at the University of Pittsburg Medical Center.

While patients will also receive antibiotics, the drugs can’t get to the fascia – the area of the body where the infection takes hold and from which it spreads.

“The fascia is the thin layer of tissue that lies between your muscles,” Pasculle explained. “They’re what allow the muscles to slide over each other. When you feel your bicep move over the other muscles in your arm, it’s the fascia between them that allows that to happen. What’s important to know is that the fascia has no blood supply.

“And when an organism gets down into that layer and multiplies and produces toxins, the white blood cells can’t get into those tissues because they’re carried by the blood. That’s why antibiotics don’t work. They are also delivered by the blood.”

The most scary thing about the infection is that it can speed so quickly along the super highway created by long stretches of fascia.

“And because there’s no blood supply, a person can be asymptomatic for a bit and by the time you know it’s there, it’s often rip-roaring,” Pasculle said.

The only way to deal with an infection of the fascia is to cut away all infected tissue – so the longer it takes before someone gets to the hospital, the more tissue will be lost.

Usually it takes a deep, penetrating wound for bacteria to get in to infect the fascia, Pasculle says. And while strep bacteria are the most common cause for necrotizing fasciitis, the deadly infection can arise from almost any of the bacteria so ubiquitous in our environment.

There’s no real protection against necrotizing fasciitis, Snyderman said. The only thing you can do is be on the lookout for symptoms.

“Everybody should treat every wound the same way, initially,” Snyderman said. “Wash it with soap and water, not hydrogen peroxide. Put on antibiotic ointment, then a bandage – and check the bandage often. If [the wound] gets red, puffy, and disproportionately painful, and/or if it looks like a bruise that is growing, you need to get to a hospital quickly.”

And make sure your doctor understands the level of your pain, Synderman said.

“Many times this is misdiagnosed by patients and doctors,” she added. “I teach residents that if a patient says it hurts like hell, don’t assume they are a wimp. Pay attention. Get the infectious disease people in there and call a surgeon.”

Though the two recent cases have drawn attention to necrotizing fasciitis, experts don’t think it’s on the rise.

“Necrotizing fasciitis has been known as long as there have been bows and arrows,” Pasculle said. “What’s required is inoculation of bacteria deep into the tissues.”

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